医患关系由“双输”到“双赢”

我国医患关系日趋紧张已是一个不争的事实,日趋恶化的医患关系使患者无奈、天使流泪、医院苦恼、政府尴尬,可谓"全盘皆输"。实现和谐医患关系达到"全赢",必须解决影响医疗服务水平的这一关键障碍,需要政府、医院、医务人员和患者多方的共同努力。     

新时期我国农村卫生服务体系的路径选择

解决好占中国人口将近70%的农民的健康问题,是全面建设小康社会中非常重要的问题。如何完善现有的卫生服务体系、构建真正惠及全体农业人口的卫生服务体系又是农村卫生事业发展的重中之重。试从制度经济学的角度出发,探讨新时期我国农村卫生服务体系的路径选择。     

Mother,Melancholia, and Art in Erik H. Erikson’s <Emphasis Type="Italic">Toys and Reasons</Emphasis>

In three earlier articles (2007a, 2007b, 2007c), I focused on the theme of the relationship of melancholia and the mother, and suggested that the melancholic self may experience humor, play, and dreams as restorative resources. In this article, I want to make a similar case, based on Erik H. Erikson’s Toys and Reasons (1977), for art (in this particular case, a painting of the Annunciation). I have made a similar case for the restorative role of art in articles on Leonard da Vinci’s Mona Lisa (Capps, Pastoral Psychology, 53, 107–137, 2004) and James McNeill Whistler’s painting of his mother (Capps, Pastoral Psychology, 2007d). In the present article, however, I focus on the special biographical circumstances in Erikson’s own development of a melancholy self and the painting he discusses in Toys and Reasons, thereby suggesting that individuals may find a particular work of art especially relevant to their own experience of melancholy. I conclude with Erikson’s testimonial at the memorial service of a colleague and friend who translated her own melancholy into her service to others.

Standing balance of children with developmental coordination disorder under altered sensory conditions

Maintenance of standing balance requires that sensory inputs be organized with the motor system. Current data regarding the influence of sensory inputs on standing balance in children with developmental coordination disorder (DCD) are limited. This study compared the influence of sensory organization and each sensory input on the standing stability between a group of 20 children, 4-6 years old, with DCD and an age- and gender-matched control group of 20 children. Three types of visual inputs (eyes open, eyes closed, or unreliable vision) and two types of somatosensory inputs (fixed or compliant foot support) were varied factorially to yield six sensory conditions. Standing stability was measured with a Kistler force plate for 30s and expressed as the center of pressure sway area. The results showed that the standing stability of the children with DCD was significantly poorer than that of the control children under all sensory conditions, especially when the somatosensory input was unreliable (compliant foot support) compared to when it was reliable (fixed foot support). The effectiveness of an individual sensory system, when it was the dominant source of sensory input, did not significantly differ between the groups. The results suggest that children with DCD experience more difficulty coping with altered sensory inputs, and that such difficulty is more likely due to a deficit in sensory organization rather than compromised effectiveness of individual sensory systems.     

Motor coordination uses external spatial coordinates independent of developmental vision

The constraints that guide bimanual movement coordination are informative about the processing principles underlying movement planning in humans. For example, symmetry relative to the body midline benefits finger and hand movements independent of hand posture. This symmetry constraint has been interpreted to indicate that movement coordination is guided by a perceptual code. Although it has been assumed implicitly that the perceptual system at the heart of this constraint is vision, this relationship has not been tested. Here, congenitally blind and sighted participants made symmetrical and non-symmetrical (that is, parallel) bimanual tapping and finger oscillation movements. For both groups, symmetrical movements were executed more correctly than parallel movements, independent of anatomical constraints like finger homology and hand posture. For the blind, the reliance on external spatial factors in movement coordination stands in stark contrast to their use of an anatomical reference frame in perceptual processing. Thus, the externally coded symmetry constraint evident in bimanual coordination can develop in the absence of the visual system, suggesting that the visual system is not critical for the establishment of an external-spatial reference frame in movement coordination.     

Use of social knowledge in tacit coordination: Social focal points

Social focal point theory predicts that, in matching, people search for a shared characteristic that makes one decision option salient whereas, in mismatching, they search for complementary characteristics that make different options salient for each of the coordinating parties. In two studies, participants learned about a partner’s activity preferences and then tried to either match or mismatch choices on a series of pictures that were remotely associated with one of these preferences. Being the same on a relevant preference facilitated matching whereas being different facilitated mismatching. In the second study, participants also used overall perceived similarity to supplement specific trait information. Coordination performance also affected interpersonal impressions: successful matching increased interpersonal attraction whereas successful mismatching did not. These downstream effects were obtained even when participants had considerable prior social information about their partners. Tacit coordination is compared with mimicry and synchrony, and the implications for coordinated team performance are discussed.     

Parentification and Alcohol Use: Conditional Effects of Religious Service Attendance

This study tested a model of the relation between parentification and alcohol use through differentiation of self (DoS), with religious service attendance as a moderator. Results provided mixed support for the model. Perceived unfair parentification was associated with decreased DoS, and lowered DoS corresponded to increased alcohol use. Religious service attendance moderated the association between increased perceived unfairness and increased alcohol use. Implications for practice focused on assessing perceived unfairness and integrating clients’ religiousness.     

‘The Good Mother and Her Clinging Child’: Patterns of Anchoring in Social Representations of Dementia Caregiving

This paper discusses the findings of a study that examined the processes of anchoring in the understanding of dementia caregiving using 29 interviews conducted in Germany with wives and daughters caring for a relative with dementia and 43 newspaper articles pertinent to the research objective. The concept of anchoring from Social Representations Theory was complemented by elements from cognitive linguistics to analyse the social representations (SRs) that served as source domains to determine what the target domain of dementia caregiving means, entails and requires. The analysis revealed three prevalent patterns of anchoring dementia care in SRs of child care and the good mother. The first pattern ascribed the role of the helpless clinging child needing his mother to the dementia patient, the second emphasised that the dementia caregivers' responsibility for caring, just like motherhood, should take precedence over all other interests and the third consisted of dementia caregivers deriving the perception of being the most suitable caregiver from the mother's natural aptitude for caring. The conclusions reached by the different patterns are argued to contribute to dementia caregivers overexerting themselves and not using support services. The clinical implications for targeting such adverse effects of the anchoring will be discussed. Copyright © 2013 John Wiley & Sons, Ltd.     

Longitudinal Effects of OCB on Cadre Selection and Pursuing a Career as Militia Cadre in the Swiss Armed Forces

In the present investigation longitudinal data obtained from recruits undergoing basic military training in the Swiss Armed Forces were used to examine the effects of organizational citizenship behavior (OCB) on a subsequent cadre selection and the willingness to voluntarily pursue a career as militia cadre. Results of the hierarchical logistic regression controlling for demographic variables, cadre recommendation, and allocation to the desired branch of service showed OCB predicted both the selection as cadre and the voluntariness to pursue a career as militia cadre. These effects show to what extent OCB may predict significant additional effort. Results are discussed with regard to further examination of the effects of OCB on career outcomes and selection decisions.